从脏腑整体观论治糖尿病  

Treating Diabetes Based on the Holistic View of Zang-fu Organs

作　　者：林湘东[1] 向茗[2] 陈新宇[1] LIN Xiangdong;XIANG Ming;CHEN Xinyu(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China;Department of Diagnostics in Chinese Medcine,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学中医,湖南长沙410208

出　　处：《湖南中医药大学学报》2021年第11期1787-1791,共5页Journal of Hunan University of Chinese Medicine

基　　金：湖南省科学技术厅重点领域研发计划(2019SK2321);湖南省发改委创新引导专项(湘发改投资2019-412号);湖南省中医药管理局心病“四时调阳”重点研究室建设专项;湖南省教育厅优秀青年项目(18B240)。

摘　　要：基于脏腑整体观,本文从脾胃、肝胆、肾命门及心肺4部分详细论述糖尿病的病因病机和治法方药,提出膏浊困脾、肝失疏泄、肾失气化、心肺失调导致“脾不散精”是糖尿病发病的关键因素。临证将其分为膏浊困脾、中满内热、脾胃虚损、肝郁化火、肝郁脾虚、肝肾阴虚、胆郁痰扰、肾阴亏虚、肾阳亏虚、阴阳两虚、气阴两虚、痰瘀互结基本证侯,治以健脾和胃、开郁清热、疏肝理脾、清肝泻火、滋补肝肾、滋阴补阳、益气养阴、化痰通络等法。Based on the holistic view of Zang-fu organs,this article elaborates the etiology,pathogenesis and prescription of diabetes from four parts:spleen and stomach,liver and gallbladder,kidney and Mingmen,heart and lungs.It is proposed that spleen impaired by Gaozhuo,failure of liver to convey and disperse,disfunction of kidney for activation of Qi and cardiopulmonary disorders leading to“spleen failing to disperse nutrients”are the key factors in the onset of diabetes.Clinical syndromes are divided into basic syndromes of spleen impaired by Gaozhuo,middle full internal heat,deficiency of spleen and stomach,liver stagnation and generates fire,liver stagnation and spleen deficiency,liver stagnation and kidney Yin deficiency,bile stagnation and phlegm disturbance,deficiency of kidney Yin,deficiency of kidney Yang,deficiency of Yin and Yang,deficiency of Qi and Yin,and mutual knot of phlegm and stasis.The treatment methods include:invigorating the spleen and stomach,relieving stagnation and clearing away heat,soothing the liver and regulating the spleen,clearing liver-fire,nourishing the liver and kidney,nourishing Yin and tonifying Yang,nourishing Qi and Yin,eliminating phlegm and freeing channels.

关 键 词：糖尿病 脏腑辨证 健脾和胃 疏肝理脾 滋补肝肾 化痰通络 

分 类 号：R255.4[医药卫生—中医内科学]